Anal Cancer Screening Guidelines for PLHIV
Last updated: November 2024
Useful links & References
Useful Links
Summary of Australian recommendations for anal cancer screening in PLHIV
Download the Summary here
Published January 2025 by ASHM. Guidance provided on this resource is based on guidelines and best practices at time of publication
References
1. Sadlier C, Lynam A, Kerr C, et al. Anal cancer in people living with HIV: A case series International Journal of STD and AIDS 2020;31:82-82.
2. Deshmukh A, Damgacioglu H, Georges D, et al. Global burden of HPV-attributable squamous cell carcinoma of the anus in 2020, according to sex and HIV status: A worldwide analysis. International Journal of Cancer 2023;152:417-28.
3. Grulich A, Jin F, Poynten I. Anal Cancer. In: Thun M, Linet M, Cerhan J, et al., eds. Schottenfeld and Fraumeni cancer epidemiology and prevention. Fourth ed. New York, NY Oxford University Press 2018:707 – 14.
4. van Leeuwen M, Vajdic C, Middleton M, et al. Continuing declines in some but not all HIV-associated cancers in Australia after widespread use of antiretroviral therapy. AIDS 2009;23:2183-90.
5. Wong I, Grulich A, Poynten I, et al. Time trends in cancer incidence in Australian people living with HIV between 1982 and 2012. HIV Medicine 2022;23:134-45.
6. D’Souza G, Wiley D, Li X, et al. Incidence and epidemiology of anal cancer in the multicenter AIDS cohort study. J Acquir Immune Defic Syndr 2008;48(4):491-99.
7. Colon-Lopez V, Shiels M, Machin M, et al. Anal cancer risk among people with HIV infection in the United States. Journal of Clinical Oncology 2018;36:68-75.
8. Legarth R, Helleberg M, Kronborg G, et al. Anal carcinoma in HIV-infected patients in the period 1995–2009: a Danish nationwide cohort study. Scandinavian Journal of Infectious Diseases 2013;45:453-59.
9. Perkins R, Guido R, Castle P, et al. 2019 ASCCP Risk-Based Management Consensus Guidelines for Abnormal Cervical Cancer Screening Tests and Cancer Precursors. Journal of Lower Genital Tract Disease 2020;24:102–31.
10. Palefsky J, Lee J, Jay N, et al. Treatment of Anal High-Grade Squamous Intraepithelial Lesions to Prevent Anal Cancer. New England Journal of Medicine 2022;386:2273-82.
11. Rim S, Beer L, Saraiya M, et al. Prevalence of anal cytology screening among persons with HIV and lack of access to high-resolution anoscopy at HIV care facilities. JNCI: Journal of the National Cancer Institute 2024;116:1319–32.
12. Australasian Society for HIV Medicine VHaSHM. Anal Cancer in People Living with HIV 2021 [accessed 13th August 2024.
13. Jones M, Carroll S, Martin J, et al. Management of early anal cancer: need for guidelines and standardisation. International Journal of Colorectal Disease 2017;32:1719-24.
14. Network. NCC. NCCN Clinical Practice Guidelines in Oncology – Anal Carcinoma. Version 2.2017 2017 [accessed 13th August 2024 2024.
15. Janczewski L, Faski J, Nelson H, et al. Survival outcomes used to generate version 9 American Joint Committee on Cancer staging system for anal cancer. CA: A cancer journal for clinicians 2023;73:516-623.
16. Cheng Q, Poynten I, Jin F, et al. Cost-effectiveness of screening and treating anal pre-cancerous lesions among gay, bisexual and other men who have sex with men living with HIV. The Lancet Regional Health – Western Pacific 2023;32:100676.
17. Stier E, Clarke M, Deshmukh A, et al. International Anal Neoplasia Society’s consensus guidelines for anal cancer screening. International Journal of Cancer 2024;154:1694-702.
18. Anonymous. Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents With HIV America https://clinicalinfo.hiv.gov/en/ guidelines/adult-and-adolescent-opportunistic-infection2024 [Q1]. accessed 2nd August 2024 2024.
19. Piketty C, Cochand-Priollet B, Lanoy E, et al. Lack of regression of anal squamous intraepithelial lesions despite immune restoration under cART AIDS 2013;27(3):401-06.
20. Nakagawa F, May M, Phillips A. Life expectancy living with HIV: recent estimates and future implications. Current Opinion in Infectious Diseases 2013;26:17-25.
21. Crum-Cianflone N, Hullsiek K, Marconi V, et al. Anal cancers among HIV-infected persons: HAART is not slowing rising incidence. AIDS 2010;24:535-43.
22. Silverberg M, Lau B, Justice A, et al. Risk of anal cancer in HIV-infected and HIV-uninfected individuals in North America. Clinical Infectious Diseases 2012;54(7):1026-34.
23. Dal Maso L, Polesel J, Serraino D, et al. Pattern of cancer risk in persons with AIDS in Italy in the HAART era. British Journal of Cancer 2009;100:840-47.
24. Jin F, Vajdic C, Poynten I, et al. Cancer risk in people living with HIV and solid organ transplant recipients: a systematic review and meta-analysis. Lancet Oncology 2024;25:933-44.
25. Welfare AIoHa. Cervical screening in Australia 2012–2013. http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=60129550872 ed. Canberra: AIHW, 2015.
26. Clifford G, Georges D, Shiels M, et al. A meta-analysis of anal cancer incidence by risk group: Toward a unified anal cancer risk scale. International Journal of Cancer 2021;148:38-47.
27. Benson AB, Venook AP, Al-Hawary MM, et al. Anal Carcinoma, Version 2.2023, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw 2023;21(6):653-77. doi: 10.6004/jnccn.2023.0030
28. Cappello C, Cuming T, Bowring J, et al. High-Resolution Anoscopy Surveillance After Anal Squamous Cell Carcinoma: High-Grade Squamous Intraepithelial Lesion Detection and Treatment May Influence Local Recurrence. Dis Colon Rectum 2020;63(10):1363-71. doi: 10.1097/dcr.0000000000001750
29. Mayo Clinic. Anal cancer: Mayo Foundation for Medical Education and Research (MFMER); 2023 [Available from: https://www.mayoclinic.org/diseases-conditions/anal-cancer/symptoms-causes/syc-20354140#:~:text=Anal%20cancer%20can%20cause%20symptoms,might%20be%20mistaken%20for%20hemorrhoids. accessed Jul 24 2024.
30. Pineda CE, Welton ML. Management of anal squamous intraepithelial lesions. Clin Colon Rectal Surg 2009;22(2):94-101. doi: 10.1055/s-0029-1223840 [published Online First: 2010/05/04]
31. Clarke M, Deshmukh A, Suk R, et al. A Systematic Review and Meta-Analysis of Cytology and HPV-related Biomarkers for Anal Cancer Screening Among Different Risk Groups. International Journal of Cancer 2022
32. Poynten I, Jin F, Garland S, et al. HIV, Immune Dysfunction, and the Natural History of Anal High-Risk Human Papillomavirus Infection in Gay and Bisexual Men. Journal of Infectious Diseases 2021;224:246-57.
33. Roberts J, Poynten I, Molano M, et al. Human Papillomavirus Genotypes in Anal High-Grade Squamous Intraepithelial Lesion (HSIL): Anal Intraepithelial Neoplasia Grades 2 (AIN2) and 3 (AIN3) Are Different. Cancer Epidemiol Biomarkers Prev 2020;29:2078-83.
34. Lin C, Franceschi S, Clifford G. Human papillomavirus types from infection to cancer in the anus, according to sex and HIV status: a systematic review and meta-analysis. Lancet Infectious Diseases 2018;18(2):198-206.
35. Koliopoulos G, Nyaga V, Santesso N, et al. Cytology versus HPV testing for cervical cancer screening in the general population. Cochrane Database Syst Rev 2017;8:CD008587.
36. Poynten I, Jin F, Roberts J, et al. The Natural History of Anal High-grade Squamous Intraepithelial Lesions in Gay and Bisexual Men. Clin Infect Dis 2021;72:853-61.
37. Jin F, Grulich A, Poynten I, et al. The performance of anal cytology as a screening test for anal HSILs in homosexual men. Cancer Cytopathology 2016;124(6):415-24.
38. Jin F, Poynten I, Hillman R, et al. Does use of anal cytology as a triage test improve the performance of high-risk human papillomavirus screening in gay and bisexual men for anal cancer prevention? International Journal of Cancer 2024
39. Hillman R, Berry-Lawhorn J, Ong J, et al. International Anal Neoplasia Society Guidelines for the Practice of Digital Anal Rectal Examination. Journal of Lower Genital Tract Disease 2019;23:138-46.
40. Burgos J, Curran A, Landolfi S, et al. The effectiveness of electrocautery ablation for the treatment of high-grade anal intraepithelial neoplasia in HIV-infected men who have sex with men. HIV Medicine 2016;17(7):524-31.
41. McCloskey J, Hall J, Phillips M, et al. Successful treatment of anal intraepithelial neoplasia by CO2 laser in a sexual health service. Sexual Health 2013;10:581-82.
42. Goldstone SE, Lensing SY, Stier EA, et al. A randomized clinical trial of infrared coagulation ablation versus active monitoring of intra-anal high-grade dysplasia in HIV-infected adults: An AIDS Malignancy Consortium trial. Clin Infect Dis 2019;68:1204-12. doi: 10.1093/cid/ciy615 [published Online First: 2018/07/31]
43. Goldstone S, Hundert J, Huyett J. Infrared Coagulator Ablation of High-Grade Anal Squamous Intraepithelial Lesions in HIV-Negative Males Who Have Sex with Males. Dis Colon Rectum 2007;50:565-75.
44. Goldstone R, Goldstone A, Russ J, et al. Long-term follow-up of infrared coagulator ablation of anal high grade dysplasia in men who have sex with men. Diseases of the Colon and Rectum 2011;54:1284-92.
45. Haviland S, O’Donnell M. Condyloma and Anal Dysplasia. Surgical Clinics of North America 2024;104:517-27.
46. Brogden D, Walsh U, Pellino G, et al. Evaluating the efficacy of treatment options for anal intraepithelial neoplasia: a systematic review. International Journal of Colorectal Disease 2021;36:213-26.
47. Singh J, Kuohung V, Palefsky J. Efficacy of trichloroacetic acid in the treatment of anal intraepithelial neoplasia in HIV-positive and HIV-negative men who have sex with men. J Acquir Immune Defic Syndr 2009;52:474-79.
48. Richel O, Wieland U, de Vries H, et al. Topical 5-fluorouracil treatment of anal intraepithelial neoplasia in human immunodeficiency virus-positive men. Brisitsh Journal of Dermatology 2010;163:1301-07.
49. Stier E, Goldstone S, Einstein M. Safety and efficacy of topical Cidofovir to treat high-grade perianal and vulvar intraepithelial neoplasia in HIV-positive men and women. AIDS 2013;27:545-51.
50. van der Snoek E, den Hollander J, van der Ende M. Imiquimod 5% cream for five consecutive days a week in an HIV-infected observational cohort up to 32 weeks in the treatment of high-grade squamous intraepithelial lesions. Sexually Transmitted Infections 2015;91
51. Swedish K, Factor S, Goldstone S. Prevention of recurrent high-grade anal neoplasia with quadrivalent HPV vaccination of men who have sex with men: a nonconcurrent cohort study. Clinical Infectious Diseases 2012;54:891-98.
52. Wilkin T, Chen H, Cespedes M. A Randomized, Placebo-Controlled Trial of the Quadrivalent Human Papillomavirus Vaccine in Human Immunodeficiency Virus-Infected Adults Aged 27 Years or Older: AIDS Clinical Trials Group Protocol A5298. Clin Infect Dis 2018;67:1339-46.
53. Deshmukh A, Cantor S, Fenwick E, et al. Adjuvant HPV vaccination for anal cancer prevention in HIV-positive men who have sex with men: The time is now. Vaccine 2017;35:5102-09.
54. Gosens K, van der Zee R, van Heukelom M, et al. HPV vaccination to prevent recurrence of anal intraepithelial neoplasia in HIV+ MSM. AIDS 2021;35:1753-64.
55. Wei F, Gaisa M, D’Souza G, et al. Epidemiology of anal human papillomavirus infection and high-grade squamous intraepithelial lesions in 29 900 men according to HIV status, sexuality, and age: a collaborative pooled analysis of 64 studies. Lancet HIV 2021;8:e531-e43.
56. McMahon K, Gemma N, Clapp M. Relationship between anal cancer recurrence and cigarette smoking. World J Clin Oncol 2023;14:259-64.
57. Aune D, Giovannucci E, Boffetta P. Fruit and vegetable intake and the risk of cardiovascular disease, total cancer and allcause mortality—a systematic review and doseresponse meta-analysis of prospective studies. Journal of Epidemiology 2017:1029-56.
58. Brown J, Gilmore L. Physical Activity Reduces the Risk of Recurrence and Mortality in Cancer Patients. Exerc Sport Sci Rev 2020;48:67-73.
Resources
Legal
About Us
Contact Us
ASHM Head Office – Sydney
Level 3, 160 Clarence Street Sydney, NSW 2000
Tel: (+61) 02 8204 0700 Fax: (+61) 02 8204 0782
Acknowledgement of Country
ASHM acknowledges the Traditional Owners of Country across the various lands on which we live and work. We recognise Aboriginal and Torres Strait Islander peoples’ continuing connection to land, water, and community and we pay our respects to Elders past and present. ASHM acknowledges Sovereignty in this country has never been ceded. It always was, and always will be, Aboriginal land.
ASHM Health | ABN 48 264 545 457 | CFN 17788 | Copyright © 2024 ASHM
- Useful Links
- References